Essential Medical List Expands to Include Key Treatments for Cancer and Diabetes
In a significant move towards better global health, the list of essential medications has been updated to include new treatments for cancer, diabetes, and related conditions like obesity. The new list also includes treatments for cystic fibrosis, psoriasis, haemophilia, and certain blood disorders.
The essential medications list, which is used by over 150 countries as a guide for public sector procurement, supply of medicines, and insurance reimbursement schemes, has been updated for the 24th time. The list is designed to address the priority health needs of populations.
New Additions Highlight the Importance of Public Health Impact
The new updates to the list are a crucial step towards expanding access to new medicines with proven clinical benefits and a high potential for global public health impact. The list, which was initially created in 1977 to improve access to medicines in developing countries, is now a trusted global policy tool for decisions relating to the selection and universal coverage of medicines within all health systems.
The expert committee responsible for the selection and use of essential medicines reviewed 59 applications, including 31 proposals for the addition of new medicines or medicine classes. As a result, 20 new medicines were added to the adult list and 15 to the children's list. The updated lists now include a total of 523 essential medicines for adults and 374 for children, reflecting the most pressing public health needs.
Focusing on Cancer Treatments
Cancer, the second leading cause of death worldwide, takes nearly 10 million lives each year and accounts for almost one-third of premature deaths from noncommunicable diseases. This makes cancer treatments a major focus of the essential medicines list.
The expert committee applies rigorous criteria to recommend only those therapies that offer the greatest clinical benefit. As a result, few approved cancer medicines are included – only those proven to prolong life by at least 4-6 months.
Notably, the committee recommended increasing access to a class of immunotherapy medicines that help the body’s immune system recognize and attack cancer cells more effectively. Such treatments were added to the list as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer.
Addressing Diabetes and Obesity Treatments
Diabetes and obesity, two of the most pressing health challenges facing the world today, are closely linked and can lead to serious health problems, including heart disease and kidney failure. Over 800 million people were living with diabetes, with half going untreated. At the same time, more than 1 billion people worldwide are affected by obesity, with rates rising especially fast in low- and middle-income countries.
Strong scientific evidence shows that a group of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists can help people with type 2 diabetes, especially those who also have heart or kidney disease. These medicines can improve blood sugar control, reduce the risk of heart and kidney complications, support weight loss, and even lower the risk of early death.
A number of GLP-1 receptor agonists have been added to the essential medicines list. They are used as glucose lowering therapy for adults with type 2 diabetes mellitus with established cardiovascular disease or chronic kidney disease and obesity.
Unfortunately, the high prices of these medicines are limiting access to them. Prioritizing those who would benefit most, encouraging generic competition to drive down prices, and making these treatments available in primary care – especially in underserved areas – are key to expanding access and improving health outcomes.
Maintaining Access to Essential Medicines
A large portion of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that should be financially accessible to everyone. Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centred programmes that leave no one behind.
More details of the expert committee’s recommendations, including the additions, changes, removals of medicines and formulations, and decisions not to recommend certain medicines, are available in the executive summary.
The meeting of the expert committee on the selection and use of essential medicines was held at the global health organization's headquarters. The committee, made up of recognized specialists from academia, research and the medical and pharmaceutical professions, considered a total of 59 applications. They assessed the scientific evidence on each medicine’s effectiveness, safety, comparative cost, and overall cost-effectiveness to inform its recommendations. The Model Lists are updated every two years to address new health challenges, prioritize highly effective therapeutics, and improve affordable access.